Quality news, views and analysis of issues that affect and inform us in the Douglas Shire.

The COVID-19 Report

LOCAL specialist Dr Doug Quarry from International SOS reports in on this week’s developments in the pandemic world.

DR DOUG QUARRY


In this edition:

1. How many approved COVID-19 vaccine doses does the US have in the pipeline?

2. Progress towards herd immunity in the US 

3. US COVID-19 numbers take a “concerning shift” 

4. Vaccination “is going to take the UK into a very different world in the next few months”

5. Pfizer COVID-19 vaccine reduces transmission after one dose 

6. Canada authorises AstraZeneca’s COVID-19 vaccine 

7. Results that indicate vaccination reduces transmission 

8. EU countries report offers for 900 million COVID vaccines by “alleged intermediaries”

9. While being directed to poorer, harder-to-reach areas, J&J vaccine is not “inferior”

10. COVAX – Ghana receives vaccine 


1. How many approved COVID-19 vaccine doses does the US have in the pipeline? 

ABC News tweets that Pfizer,  Moderna, and Johnson &  Johnson are expected to provide the US with enough doses to vaccinate 130 million Americans by the end of March.


2. Progress towards herd immunity in the US 

Vincent Rajkumar*** has been assessing progress towards herd immunity in the US. 

His figures: 

• 30 million have had COVID 

• 50 million have received at least one dose of vaccine 

• 70 million are children; not eligible for vaccine. 

After considering some overlap in three groups: 

• 140 million to be vaccinated to get 80% of eligible population immune • With J&J approval, this goal is achievable within 3-4 months. 

Maybe sooner? 

• 30 million have already had COVID 

• It is likely 2-3 times more have had undiagnosed COVID but are immune nevertheless • My estimates are conservative 

• So we are likely much closer to the goal 

*** Vincent Rajkumar: Professor, Mayo Clinic; Editor, Blood Cancer Journal; Oncologist. 


3. US COVID-19 numbers take a “concerning shift” 

WebMD reports that after several weeks of declining, COVID-19 numbers are beginning to rise – just as states begin to lift restrictions and open doors to restaurants and businesses. CDC Director Rochelle Walensky, reported on 28 February a 7-day average of 66,000 cases and 1,900 deaths per day. On 1 March, those numbers had increased to 66,350 and 2000, respectively.  “Given the trends we’ve seen in the last couple of days, we can’t be lifting restrictions right now,”  Walensky said.


4. Vaccination “will take the UK into a very different world in the next few months” 

BBC reports that England’s Deputy Chief Medical Officer, Prof Jonathan Van-Tam, said that the UK  vaccine programme “is going to hopefully take us into a very different world in the next few months”. But  he said it was “absolutely critical” that second doses “are still part of the course of immunisation against  COVID-19 and no less important”. 

Second dose important 

Prof Van-Tam stressed there was a “significant likelihood” that a second dose of a vaccine would “mature your immune response, possibly make it broader and almost certainly make it last longer than it would  otherwise be in relation to a first dose only.” 

Public Health England (PHE) data 

The BBC also reported on PHE data (which has not been peer reviewed) which suggested the Pfizer  vaccine: 

• Leads to an 83% reduction in deaths from COVID-19 for people over the age of 80

• Cuts the risk of people over 70 developing any COVID-19 symptoms by around 60%, three weeks  after an initial dose 


5. Pfizer COVID-19 vaccine reduces transmission after one dose 

Reuters reports: “…a single dose of the Pfizer COVID-19 vaccine cuts the number of asymptomatic  infections and could significantly reduce the risk of transmission of the virus, results of a UK study found  on Friday. 

Researchers analysed results from thousands of COVID-19 tests carried out each week as part of  hospital screenings of healthcare staff in Cambridge. 

“Our findings show a dramatic reduction in the rate of positive screening tests among asymptomatic  healthcare workers after a single dose of the Pfizer-BioNTech vaccine,” said Nick Jones, an infectious  diseases specialist at Cambridge University Hospital, who co-led the study. 


6. Canada authorises AstraZeneca’s COVID-19 vaccine 

WebMD reports that: “Health Canada…approved the AstraZeneca coronavirus vaccine for all adults aged 18 and older on 26 February.” Both vaccine manufactured in England and India were approved.


7. Results that indicate vaccination reduces transmission 

Dr Monica Gandhi**** has collected data suggesting that vaccines reduce transmission. 

Dr Gandhi tweeted: “It is beyond sheer biological plausibility that vaccine-mediated immune responses  block viral replication in the nose, through which you are most likely to spread the virus, as effectively as it  blocks replication elsewhere.” 

1. Lancet preprint showed that healthcare workers in UK swabbed every two weeks after vaccination  had an 86% reduction in asymptomatic infection compared with unvaccinated individuals 

2. Other data in Lancet – healthcare workers vaccinated had 85% reduction in infection (asymptomatic  & symptomatic) 15-28 days after second dose 

3. Same data among healthcare workers in Mayo Clinic system showing reduction of 88.7% of  symptomatic and asymptomatic infection after vaccination 

4. Study from Israel across a more general population (not healthcare workers) showed same finding of  92% reduction in ANY infection, even asymptomatic, with 2-dose vaccination 

5. Johnson & Johnson FDA data told us asymptomatic infection reduced by 74.2% after their 1-dose  (you can tell if someone was infected by looking at nucleocapsid seroconversion instead of spike  protein + asymptomatic swabbing) 

6. Finally, two studies that swabbed noses after vaccination (Israel, Pfizer) found, that even if you are  exposed and try to set up viral loads in your nose, nasal replication stopped early and you have low  RNA and are not infectious 


8. EU countries report offers for 900 million COVID vaccines by “alleged intermediaries” 

Reuters reports that: “Several European Union countries have reported offers from “alleged  intermediaries” for 900 million doses of COVID-19 vaccines for some 12.7 billion euros, the bloc’s anti fraud agency OLAF said on Thursday. 

“To date, all these different offers together represent over 900 million vaccine doses for a total asking  price of roughly 12.7 billion euros ($15.53 billion).” 

Pharmaceutical companies that manufacture vaccines against the coronavirus say they only sell directly to governments.


9. While being directed to poorer, harder-to-reach areas, J&J vaccine is not “inferior” 

Eric Feigl Ding***** has tweeted about the growing misconception that decisions to use the Johnson &  Johnson (J&J) vaccine in “harder-to-reach” communities are wrong as the vaccine gives 100% protection  against deaths as do the Pfizer and Moderna vaccines. 

Use of the vaccine in more difficult situations makes practical sense, because the J&J single-shot vaccine  is easier to store/use. However, this could drive misperceptions of a two-tiered vaccine system, with  marginalised communities getting what they think is an inferior product. 

***** Eric Liang Feigl-Ding is an American public health scientist who is currently a Senior Fellow at the  Federation of American Scientists in Washington DC. He was formerly a faculty member and researcher  at Harvard Medical School and Harvard T.H. Chan School of Public Health. 


10. COVAX – Ghana receives vaccine 

The New York Times reports that: “Last week, a cargo plane landed in Ghana with 600,000 doses of  vaccine developed in Britain and manufactured in India, the start of a program to deliver at least 1.3 billion  shots to 92 low- and middle-income countries this year through COVAX, an international effort backed by  the World Health Organization (WHO). 

“The effort has had a rocky start. Under the Trump administration, the US pulled out of the WHO altogether, and along with other wealthy nations it grabbed what vaccine it could for itself.  

“But the Biden administration has moved quickly to rejoin the WHO and has pledged $4 billion to the  global vaccination drive.  

“President Emmanuel Macron of France has further suggested that instead of money, wealthy countries  should donate vaccine doses to African governments, sparing COVAX the need to compete for existing  supplies.”


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